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Published on: August 28, 2018
Cigarette smoking and arteriographically demonstrable coronary artery disease
Insights
Cigarette consumption is linked to the severity of coronary artery disease (CAD). Higher pack-year history correlates with more severe CAD, and nonsmokers with CAD are older than smokers with CAD.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Cigarette smoking is a known risk factor for cardiovascular disease.
- The relationship between smoking quantity and coronary artery disease (CAD) severity requires further elucidation.
Purpose of the Study:
- To investigate the correlation between cigarette consumption and the extent of coronary artery disease (CAD).
- To assess the impact of smoking on the development and severity of CAD.
Main Methods:
- Retrospective analysis of patients undergoing selective coronary arteriography.
- Quantification of pack-year smoking history and correlation with CAD severity (no lesions, single-vessel, double-vessel, triple-vessel disease).
- Comparison of age and smoking status between patients with and without significant CAD, and analysis of CAD prevalence in relation to hypertension in nonsmokers.
Main Results:
- A positive correlation was observed between pack-year history and CAD severity.
- Nonsmokers with significant CAD were significantly older than their smoking counterparts.
- A significantly lower proportion of nonsmokers had demonstrable CAD compared to smokers.
- Hypertension was associated with a higher prevalence of CAD in nonsmokers.
Conclusions:
- Cigarette consumption is directly correlated with the severity of coronary artery disease (CAD).
- Smoking accelerates the development of CAD.
- Symptomatic CAD in normotensive nonsmokers appears to be uncommon.
Abstract:
Patients undergoing selective coronary arteriography were studied to determine whether the extend of their coronary artery disease (CAD) was related to cigarette consumption. Those without demonstrable lesions averaged 29.0 pack years. Patients with single vessel disease, 38.3 pack years, those with double vessel disease 44.9 pack years and those with triple vessel disease 67.5 pack years. Nonsmokers with significant CAD were ten years older than their smoking counterparts (p less than 0.01). Forty-seven percent of patients with no demonstrable disease were nonsmokers whereas only 18 percnet of those with CAD were nonsmokers (p less than 0.001). Sixty-nine percent of nonsmoking normotensive patients had no CAD whereas only 23 percent of nonsmoking hypertensive patients fell in the no CAD category (p=0.01-0.005). This study demonstrates a correlation between the number of cigarettes consumed and the severity of CAD as well as the accelerating effect of cigarette consumption on the development of CAD. It also suggests that symptomatic CAD in a normotensive nonsmoker is unusual.
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